Trace ketones, cat running fever - need advice

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wombat88

wombat88

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I just tested Shaikha and got a reading of 0.2 on ketones on my Abbott Precision Xtra meter. I know that is only a trace, but she's also got a fever right now and has not been eating well. Her blood glucose level is surprisingly good (169 in my most recent test) despite having a temp of 103.4 this morning. She's never thrown ketones before though, so I am worried. She gets insulin again in about 20 more minutes (she's on TID).

Shaikha has chronic pancreatitis along with IBD and liver problems. She's always tested 0.0 on the meter, even when she has run a high fever. Her pancreatitis is flaring up badly right now and she's been running a fever since Sunday. We've got her on antibiotics, subQ fluids, and buprenorphine. Her appetite has improved but the fever is still present but she's only been on zeniquin since yesterday. She tends to spike fevers in bad attacks, so this isn't unusual. Her urine was clear, so the fever appears to be related to the pancreatitis.

She's been very inappetant, but I've been assist feeding though she's not gotten as much food as typical. This morning she wanted to eat and polished off a full can of Fancy Feast so it isn't like she's not had any food today.

Given the fact that she's not eating normally and is sick, any ketones worry me. She got 100ml subQ fluids this AM and seems adequately hydrated, but I will check her again this afternoon and if she seems to need more I'll give them to her. I know that pancreatitis is dehydrating and with the fever, she's got a double whammy.

How often do I need to be testing for these and when do I need to worry?
 
I'm no expert but even if she has normal blood ketones at 0.0, the 0.2 number isn't alarming. It is if it crawls up to 0.4 and more, that she can be ketonic. But from that you still can't tell if she is acidic too, only the vets can measure the oxygene-acid base levels.

I can't tell the fever number since it is in F, but most be high.


Is there a hospital you could call, since she might need a boost of iv-antibiotics?
 
I wish I could offer some help, but I have no experience with it.
All I can offer is sending healing vibes.
Hopefully someone will be along shortly.

((((hugs))))
 
I just talked to my vet and he wants me to give her more subQ fluids now. Her gums are not tacky and skins snaps back fine but with the fever and pancreatitis I don't think they will hurt. I'm to keep monitoring her glucose and test again for ketones this afternoon. If she's still throwing trace ketones I'm to take her in for IV fluids tomorrow and stronger antibiotics. If ketones increase, I'm to call him again so we can address the problem sooner. She's having an awful pancreatitis attack right now so has been a pretty sick cat the past few days. And yes, her fever is high. Anything over 102.5 is abnormal, I think. She's run higher fevers with past attacks.
 
There was a thread last night, where Nancy responded about .2 ketone readings on the blood meter. I know it is alarming but I think .2 is normal.
 
wombat88 said:
I just talked to my vet and he wants me to give her more subQ fluids now. Her gums are not tacky and skins snaps back fine but with the fever and pancreatitis I don't think they will hurt. I'm to keep monitoring her glucose and test again for ketones this afternoon. If she's still throwing trace ketones I'm to take her in for IV fluids tomorrow and stronger antibiotics. If ketones increase, I'm to call him again so we can address the problem sooner. She's having an awful pancreatitis attack right now so has been a pretty sick cat the past few days. And yes, her fever is high. Anything over 102.5 is abnormal, I think. She's run higher fevers with past attacks.
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Good call, you're on top of it. Giving Shaikha hugs and feel better thoughts from here. And hugs to you so you also goes through it too.
 
Okay, just read this again .... 0.2 is not trace on a meter. Even if you go by the manual, up to 0.6 can be normal. Are you using urine strips? I tend to use them more than the meter and will pull the meter out if the urine is showing ketones.

Also, she is small, if you gave her 100 ml this AM I wouldn't give her more now, especially to get an almost nothing ketone reading down more. Hope keeps telling me how dangerous SQ can be if over-used, so I try and err on the side of caution.

It is NORMAL for a cat to throw off some ketones during a pancreatitis flare-up, which she is having now, you are doing everything right, just make sure she gets enough insulin,
 
Thanks so much, Nancy. I have ketostix, but never have been able to catch her in the box. She's very private. I do have some hydrophobic sand but haven't tried using it before. I don't know if she'd use a new box with it in there or not. Like I said, she's very private with her litterbox habits.

SubQ fluids can be dangerous if you overdo them, that's true. The key is ensuring whether fluids were fully absorbed before giving more. I do not feel any fluid pockets so she seems to have sucked them all down since earlier today. Usually I give her 75-100ml a day when she's got an attack, depending on how quickly she seems to absorb them and how badly she's doing. In past times she's been like this I've given as much as 150 ml in day split into two sessions with no issues. Don't worry, I'll be careful. My GA Tabriz got fluid therapy for years for renal failure, so an IV bag has been a permanent part of my kitchen decor between him and now Shaikha.
 
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